Oxygen is a prime element, necessary for the existence of all living animals and vegetation. No living thing can exist more than a few minutes without it, and no living thing can function normally without an adequate supply of it.

In 1774 Priestly isolated some gas from the atmospheric air. In the years following, Lavoisier studied this gas and named it oxygen. Up to the present time experiments and tests have revealed the following: that oxygen is a colorless, odorless, tasteless gas, its atomic weight is 16; it is the most important and abundant element discovered and is essential to life. Its combination with other elements forms oxides. Free in the atmosphere and by weight, it constitutes 3/4 of the animal, 4/5 of the vegetable, 1/2 of the mineral kingdoms, and by volume 1/5 of the atmosphere, and 8/9 by weight of water. It is the only element that enters the animal organism in a free state. It is absorbed by plants in the form of water and carbon dioxide, being converted by them into organic substances utilized for the food of man, and in turn being returned to the atmosphere by man in form of waste products of water and carbon dioxide, thus maintaining the balance of oxygen and carbon dioxide in the atmosphere. It represents 65% of the elements in the body, 12% in the venous, and 20% in the arterial blood.

Priestly and others conducted experiments on animals, and discovered that the life of an animal, like the life of a candle flame, was dependent upon the continued removal of oxygen from the atmosphere and an equivalent return of carbon dioxide, and that the amount of oxygen consumed was related to the amount of heat developed, and to the amount of work performed, and that the chemical changes that took place in the body were in the nature of combustion and this combustion was termed oxidation. It was the oxidation of carbon to carbon dioxide in the body. From these experiments was laid the foundations of biochemistry and it is still supposed to be, by definition at least, the foundation axiom of the science of metabolism, i.e., that the energy required by the animal for growth, maintenance, and function is derived from the oxidation of organic nutrients and that oxygen is the prime oxidant. But biochemistry in the last decade has gone far from the original concept of the necessity of oxygen as the prime oxidant in oxidation. We are now told that oxygen is no longer a prime necessity in oxidative reactions, but that it is only one of a great host of oxidants, many of which contain no oxygen whatever. This is based on the theory that both oxygen and the metabolites are inactive, and that the facility of the reactions of oxygen and the metabolites are brought about by the presence of catalytic enzymes capable of activating both oxygen and the organic molecules. Once this theory was expounded, it was readily accepted for its commercial value, and a wild search was started for organic substitutes. The biochemist, along with the electrochemist, has followed the lead of^, the bacteriological chemist in searching for substitutes for natural body enzymes, catalyzers, serums, antitoxins, and other substances, and the search goes on now with more zeal than ever. Physicians receive stacks of literature from commercial chemical business houses. While the literature does not say so, the inference is that the correct anatomical structure of the human anatomy, and the physiological functions of the body are insignificant and that chemistry will solve all one's problems. Then is told the story of certain laboratory experiments, the resulting product of which may be a catalyzer or an enzyme or a serum that will do what the body mechanisms have failed to do. Or it may be electrochemical literature expounding the chemical changes that a certain electrical apparatus will perform. There is some virtue in all the claims made by the chemists, but not in all they claim. They expound a long list of theories and give captivating names to the various catalyzers and enzymes recommended as substitutes for correct breathing, eating, and drinking of liquids, proper hours of working, sleeping, and other sedentary habits.

Some of these are the Hydrolytic Oxidation Reduction Theory, the Electrochemical Oxidative Theory, the Kinetic, the Hydrogen, the Hydration and the De-hydration Oxidation Theories, the Psycho Chemical, Oxidative Theory, Autooxidation Theory, Reductase, Dehydrase, Hydrogen Transportase, Oxidase, Dehydrogenase Oxidoreductase, Anahydrase, Hemochromogen Compounds, et al.

This name calling of vital elements of the body and the search for substitutes may be one of the causes for the great increase in the number of chronics. While we accept some of the claims of body chemistry as of some value, we are still old-fashioned enough to cling to the old instruction that man is governed by five fundamental laws first of which is the law of oxidation that oxygen is the only oxidant. The proof of this is the fact that if a living organism is put into a vacuum, and a substitute of any nature provided for oxygen, the organism cannot live for more than a few minutes.

The manipulative physician's continued existence and success has been built on the hypothesis that if the body mechanisms are put into their proper relationships, and the body is given a proper quantity and quality of foods and liquids, and if obstructions are removed from the respiratory system, the body mechanisms, with the aid of natural oxygen create not only oxidation out of which comes the metabolic substances for energy, growth, maintenance of functions, and repair, but also create their own by-products such as catalyzers, enzymes, and immunizers. If the manipulative physician continues to make his labratory the anatomical, physiological and neurological behavior of human bodies under the varying conditions of environment, dietary and sedentary habits of life, then his success will grow even greater. More and more of, the "chronics" who have been told after elaborate laboratory research: "Nothing more can be done for you", will find their way to him.

Oliver Wendell Holmes must have felt strongly about this when he declared, "I firmly believe that if the whole materia medica could be sunk to the bottom of the sea, it would be all the better for mankind and all the worse for the fishes". The body of man is still the fundamental study for the healing arts, and the medicine manufactured within the body of man is still the best medicine. The following techniques were written for those who still cling to that hypothesis with the hope they will give even greater success to the manipulative physicians than they have hitherto enjoyed.

Estimates of the oxygen requirements of the body in health and the extent of the surfaces for the diffusion of gases are extensive and varied. Experiments of many descriptions have been carried on, and various results in weights and measures have been tabulated. Some of these are not only confusing but in many cases contradictory.

Calculations of the air-bearing surfaces of both lungs, on full inspiration for the diffusion of gases, go from 70 to as high as 140 square meters, and to as low as 50 square meters. But we can rest assured, however, that the alveolar surfaces of the lungs are well suited to permit free diffusion of gases going in both directions.

Putting the matter in a more simplified form, and striking a medium somewhere in all the other calculations, we are convinced that the lungs of the average normal adult in health has a maximum capacity of four to eight pints of air in each lung. To maintain that maximum there should be an ever-changing residual in the lungs of from three to four pints. This requires the person to breathe at least eighteen times per minute, and with each breath inhale one pint of air; and for health each pint of air must contain at least twenty units of oxygen.

The oxygen which enters the body from the atmospheric air must diffuse unhindered into the alveolar air spaces in the lungs where it goes through a process of exchange. The venous blood passing through the lungs deposits carbon dioxide, in the carbonic gas form, which is expelled on exhalation, and the hemoglobin of the blood takes on oxygen by inhalation; then, by the proper circulation of the blood the oxygen is carried via the hemoglobin to all the cell tissues. Therefore, to attain or maintain a harmony of functional activities of the body, there must be, first, a sufficient amount of oxygen in the atmospheric air to fulfill the demands of the body, and second, the removal of obstructions of every nature that would interfere with the free passage of air and oxygen into the alveolar air spaces of the lungs whence it passes through the blood stream to the tissues. Oxygen enters the body in three ways, first, through the pores of the skin; second, through the ingestion of foods and liquids; third, through the respiratory system. The last is the important one. It is doubtful if more than seven to ten percent of the required oxygen is obtained by way of the skin, or more than ten to fifteen percent by way of foods and liquids. We are certain of this, that no person could live for more than a few minutes if they depended on foods and their skin to give them the required amount of oxygen.

OXYGEN TRANSPORT, THROUGH, AND POSSIBLE OBSTRUCTIONS IN THE OPEN CAVITIES.

When we speak of open cavities we refer to those cavities that are in direct communication with external air. The closed cavities are those supplied indirectly by the open cavities and through the blood stream. All the open cavities are found in the head and throat.

Now let us name the parts of the open cavities, their functions and some of their abnormalities. The open cavities of the head are the nasal canal from the anterior to the posterior nares, the soft palate, the maxillary, frontal, ethmoidal, sphenoidal and mastoidal sinuses, the inferior, middle, superior and supreme turbinates, the tear ducts, eustachian tubes and the mucous membranes that cover all the parts named. Then there are the pharyngeal cavity and Fossa of Rosenmuller, tonsils, tongue, trachea, and epiglottis, and all the tissues that come in direct contact with atmospheric air and that receive their largest supply of oxygen freely from that source.

Taking up the functions of these parts in the order given we will also discuss what discomforts may arise by any interference with their functions.

The function of the nasal canal from the anterior to the posterior nares is to contract and expand in unison with the contraction and expansion of the lungs and diaphragm. If the walls of the nasal canal have lost their resiliency or expansile qualities and become narrowed or obstructed, sufficient air is not inhaled. In health they are filled with everchanging air, but deprived of air they cause painful symptoms. These symptoms are diagnosed as sinusitis, headache, and dizziness.

The function of the tear ducts is to carry secretions from the eyes, and in health are filled with oxygen that keeps the ducts open and the secretions in a solution possible of drainage. They also keep the eyes warm. Interference with the air getting in the duct causes running or watery eyes, red eyes, and granulated eyelids.

The function of the turbinates is to make the air travel in a zig-zag course through the nasal canal, at the same time sieving and warming it. If the turbinates are bent, twisted, broken, or fallen in such a manner that they obstruct the nasal canal or cannot perform their functions, one of two things can happen: first, little oxygen is passing through the nasal canal; second, the air which is passing through is dirty and too cold, resulting in coagulation of the mucous, and mouth breathing.

Now we come to the mucous membrane. It is a fine lining of sheath-like tissue that covers all the nasal canal and cavities like the paper on the wall of a room. The function of the mucous membrane is to protect the tissues underneath and establish a method of drainage for those tissues. This mucous membrane has thousands of tiny glands that secrete enough to keep the membrane moist and allow free drainage. If they become irritated by a lack of oxygen caused by obstructions in the nasal canal or more toxic matter than oxygen can take care of, they secrete great quantities of colorless mucous which if not thrown out quickly from the nose will become thick and if infected by germs will become white, yellow, and streaked with blood. This condition is known as "catching a cold."  Should this mucous dry lip and form a hard surface over the membrane, causing pressure on tiny nervelets, then the condition is called rhinitis. When the membrane is irritated by pollens and dust, a sneezing and burning takes place, and we have the condition called "hay fever."

Congestive catarrhal conditions in the tonsils are one of the greatest etiological factors in closing the eustachian tubes, causing inflammation of the middle ear, and often progressive or complete deafness, because of a fixation of all vibrations and oscillations of the ossicles and membrane. When the trachea becomes subluxated or the epiglottis becomes inflamed they act as barriers to the proper intake of oxygen. In addition to being impediments to the ingestion of oxygen, they experience difficulty in performing functions of their own, especially that of swallowing and speaking. Within the skull and the branchial walls of the neck are some tissues that, according to their anatomical positions and relative size, may hinder the intake and utilization of oxygen. They receive their total oxygen supply directly from the blood circulation via the hemoglobin. To mention some of them, leaving the explanations of their functions to the chapter on techniques, they are: the respiratory center, the parasympathetic nerves, the carotid glands, the thyroglossal duct (if any is retained), the thyroid, parathyroid and thymus glands; and the ten sutures that are built around the front of the face, and the lambdoidal, occipital, and mastoidal sutures, all have a direct bearing on the intake of oxygen and its utilization.

The soft palate in health is like a door that opens on inhalation and closes on exhalation. It serves three important purposes: First, it opens to allow the air to go down the trachea. Second, it closes so that foodstuff will not block up the nasal canal, and of even greater importance it prevents carbonic gases, which should come out of the mouth, from going up into the head in large quantities. Third, it always maintains a residual amount of air in the nasal canal so that the eustachian tube and mastoidal sinuses will be kept supplied. If this soft palate adheres to bones and tissues that form the boundary of the posterior nares ring, then serious complication will result, since air is not going into the eustachian tube in sufficient quantities to keep it open and pass through to the middle ear and mastoidal sinus. If, on the other hand, the soft palate performs its functions and the eustachian tubes are prolapsed, atrophied, twisted or hypertrophied with waste matter, then serious difficulties will arise in the middle ear and the mastoid process. One result may be the drying up of the mucous membrane, causing ankylosis of the small bones or the gathering of catarrhal mucous which soon becomes infected, and when inflammation sets in there is the possibility of abscesses, mastoiditis, deafness, vertigo and tinnitus aurium. Again, we repeat, there are many causes, but it is the lack of air and oxygen that is the basic reason for these troubles.

Then there are the sinuses. The function of these cavities is to give lightness and balance to the head and to act as a sounding board for the voice.

OXYGEN TRANSPORT AND OXIDATION IN THE CLOSED CAVITIES.

We can do no more here than attempt to give a brief sketch of the outline of the method whereby the body receives its supply of oxygen. Hemoglobin is the main carrier of oxygen to all parts of the body. The content, dissociation, quantity and quality of the hemoglobin in the blood are extraneous to our purpose here. It is sufficient to say that the hemoglobin has an affinity for oxygen and that as it passes through the lungs it becomes about 96% oxygenated.

After the air has passed through the nasal canal it enters the lungs. Here an exchange takes place, the venous blood loses its blue color and becomes red in the membranous plexuses of the alveoli of the lungs. The gaseous exchange in the lungs takes place in accordance with the physical laws of diffusion. That is, if a permeable membrane separates two volumes of gas at different pressures the molecules of gas will pass through the membrane in both directions until it is equal on both sides. It goes from a higher to a lower pressure and both become equal.

Oxygen in the body must be of a higher pressure because when the medium of oxygen around the cell falls it must replenish it in order to keep at an equilibrium the cell rate activity. After this exchange of carbon dioxide and oxygen has taken place in the lungs then the largest portion of oxygen is taken up in chemical combination with the hemoglobin of the red corpuscles of the blood. The smaller portion is held in solution by the plasma. These make two compounds, Oxyhemoglobin and Oxyplasma and these compounds possess the important property that when pressure of oxygen in the cell surrounding medium falls sufficiently they begin to dissociate themselves and give off free oxygen to the tissue cells. The process of dissociation is increased by exercise and by increased temperature providing it does not rise to a point of coagulating the hemoglobin.

The arterial blood enters the capillaries nearly saturated with oxygen, and as the blood passes through the capillaries which only takes about one second the blood loses, it is estimated, about 64% of its oxygen. The loss of oxygen is due to the dissociation of the oxyhemaglobin owing to the fact that in passing through the capillaries the blood is brought into exchange with a surrounding lymph cell liquid in which the oxygen pressure is very low.

After the chemical change has taken place, then it has long been recognized that a certain small percentage is held in simple physical solution in the plasma and the capillaries and that a certain larger additional amount is chemically combined with the alkali of the blood as a carbonate, most probably a bicarbonate and that carbon dioxide forms a dissociable compound with hemoglobin and a similar compound is formed with the proteins of the plasma. We then have this picture. The arterial blood passes to the tissues of closed cavities nearly saturated with oxygen as far as the hemoglobin is concerned and the oxygen is held under tension. The carbon dioxide is less in quantity than on entering the lungs and exists under smaller pressure which may be assumed to be the same as that of the carbon dioxide in the alveoli of the lungs.

On the other hand, in the systemic capillaries the blood comes into diffusion relations with the tissues and direct examination of the latter shows that the oxygen in them exists under a very small pressure while a CO₂ is present under tension. A high tension of CO₂ is explained by the fact that it is being formed in the tissues constantly as a result of cell metabolism, while the low tension of oxygen is due to the fact that on entering the tissue this substance is combined in some way in a chemical compound too firm to dissociate entirely. The physical conditions are, therefore, such as would cause a stream of CO₂ from the tissues to the blood and a stream of oxygen in the other direction.

The method in which the carbon dioxide is held in solution in the blood has long been a matter of conjecture, but now it is generally accepted that the conversion of the solids of CO₂ into a gas is brought about by an enzyme known, as carbonic anahydrase. This enzyme is derived from the erythrocytes of the blood.

With the rise of carbonic acid or gaseous content in the blood the sensory nerve endings in the aortic and carotid bodies are stimulated and these in turn send impulses to the respiratory center in the floor of the fourth ventricle of the medulla, which in turn is stimulated and breathing is quickened to an extent sufficient to meet the requirements of equilibrium. Thus the perpetual movements of respiration and expiration are maintained.